The Histological Analysis Of The Meningioma Dural Tail And Its Guide To Operation

Objective: The incidence rate of the meningioma is about 20 percent , second only to the gliocytoma. The recurrence of the meningioma is concerned with a lot of factors. To decrease the recurrence of the meningioma is one of the most important questions that the clinical neurosurgeon should face. At present, the most effective means for decreasing the recurrence of the meningioma is resection of the tumor completely. With the development of the Gd-DTPA MRI, the dural tail is defined by Wilms. The pathology of the dural tail is controversial. Some scholars considered that the dural tail is composed of tumor tissue. Others deemed that it is composed of the hyperplastic fibrous connective tissue and blood vessel dilatation. The aim of our research is to analyse the histological appearance of the dural tail accompanying the meningioma on MRI and verify the guide to operation of the dural tail.Methods: 14 meningiomas that accorded with the diagnostic criteria by Goldsher were removed with their dural tails. Six points were cut from the attachment of the tumor to the adjacent dura mater and examined histologically. We surveyed if the points were invaded by tumor-cells. The analysis was also made on the differences of the rate of tumor cell infiltration.Result: The major dural tails accompanying the meningioma are invaded by tumor-cells. It is also composed of the hyperplastic fibrous connective tissue and blood vessel dilatation. The proportion of tumor -cell invasion is 87 % in the center point of the attachment of the tumor, 87% in the margin of the tumor, 61 % in the center from the margin of the tumor to the distal site of the dural tail, 52% in the distal site of the dural tail, 13% and 0% in the 5mm point , 10mm point part from the distal site of the dural tail. The differences of the proportion of tumor-cell invasion are significantly (P<0.01).Conclusion: The major dural tails accompanying the meningioma are invaded by tumor-cells. It is also composed of the hyperplastic fibrous connective tissue and blood vessel dilatation. The proportion of tumor-cell invasion set down with the extention of...